PMID- 23641879
OWN - NLM
STAT- MEDLINE
DCOM- 20131231
LR  - 20211021
IS  - 1748-717X (Electronic)
IS  - 1748-717X (Linking)
VI  - 8
DP  - 2013 May 4
TI  - Multi-institutional comparison of treatment planning using stereotactic ablative 
      body radiotherapy for hepatocellular carcinoma - benchmark for a prospective 
      multi-institutional study.
PG  - 113
LID - 10.1186/1748-717X-8-113 [doi]
AB  - INTRODUCTION: Several single institution phase I and phase II trials of 
      stereotactic ablative body radiotherapy (SABR) for liver tumors have reported 
      promising results and high local control rates of over 90%. However, there are 
      wide variations in dose and fractionation due to different prescription policies 
      and treatment methods across SABR series that have been published to date.This 
      study aims to assess and minimize inter-institutional variations in treatment 
      planning using SABR for hepatocellular carcinoma (HCC) in preparation for a 
      prospective multi-institutional study. METHODS: Four institutions (A-D) 
      participated in this study. Each institution was provided with data from four 
      cases, including planning and diagnostic CT images and clinical information, and 
      asked to implement three plans (a practice plan and protocol plans 1 and 2). 
      Practice plans were established based on the current treatment protocols at each 
      institution. In protocol plan 1, each institution was instructed to prescribe 40 
      Gy in five fractions within 95% of the planning target volume (PTV). After 
      protocol plan 1 was evaluated, we made protocol plan 2, The additional regulation 
      to protocol plan 1 was that 40 Gy in five fractions was prescribed to a 70% 
      isodose line of the global maximum dose within the PTV. Planning methods and dose 
      volume histograms (DVHs) including the median PTV D50 (Dm50) and the median 
      normal liver volume that received 20 Gy or higher (Vm20) were compared. RESULTS: 
      In the practice plan, Dm50 was 48.4 Gy (range, 43.6-51.2 Gy). Vm20 was 15.9% 
      (range, 12.2-18.9%). In protocol plan 1, the Dm50 at institution A was higher 
      (51.2 Gy) than the other institutions (42.0-42.2 Gy) due to differences in dose 
      specifications. In protocol plan 2, variations in DVHs were reduced. The Dm50 was 
      51.9 Gy (range, 51.0-53.1 Gy), and the Vm20 was 12.3% (range, 10.4-13.2%). The 
      homogeneity index was nearly equivalent at all institutions. CONCLUSIONS: There 
      were notable inter-institutional differences in practice planning using SABR to 
      treat HCC. The range of PTV and normal liver DVH values was reduced when the dose 
      was prescribed to an isodose line within the PTV. In multi-institutional studies, 
      detailed dose specifications based on collaboration are necessary.
FAU - Eriguchi, Takahisa
AU  - Eriguchi T
AD  - Department of Radiation Oncology, Juntendo University, Tokyo, Japan.
FAU - Takeda, Atsuya
AU  - Takeda A
FAU - Oku, Yohei
AU  - Oku Y
FAU - Ishikura, Satoshi
AU  - Ishikura S
FAU - Kimura, Tomoki
AU  - Kimura T
FAU - Ozawa, Shuichi
AU  - Ozawa S
FAU - Nakashima, Takeo
AU  - Nakashima T
FAU - Matsuo, Yukinori
AU  - Matsuo Y
FAU - Nakamura, Mitsuhiro
AU  - Nakamura M
FAU - Matsumoto, Yasuo
AU  - Matsumoto Y
FAU - Yamazaki, Sadanori
AU  - Yamazaki S
FAU - Sanuki, Naoko
AU  - Sanuki N
FAU - Ito, Yoshinori
AU  - Ito Y
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20130504
PL  - England
TA  - Radiat Oncol
JT  - Radiation oncology (London, England)
JID - 101265111
SB  - IM
MH  - Benchmarking
MH  - Carcinoma, Hepatocellular/radiotherapy/*surgery
MH  - Humans
MH  - Liver Neoplasms/radiotherapy/*surgery
MH  - Prospective Studies
MH  - Radiosurgery/methods/*standards
MH  - Radiotherapy Planning, Computer-Assisted/methods/*standards
PMC - PMC3653723
EDAT- 2013/05/07 06:00
MHDA- 2014/01/01 06:00
PMCR- 2013/05/04
CRDT- 2013/05/07 06:00
PHST- 2013/03/08 00:00 [received]
PHST- 2013/04/30 00:00 [accepted]
PHST- 2013/05/07 06:00 [entrez]
PHST- 2013/05/07 06:00 [pubmed]
PHST- 2014/01/01 06:00 [medline]
PHST- 2013/05/04 00:00 [pmc-release]
AID - 1748-717X-8-113 [pii]
AID - 10.1186/1748-717X-8-113 [doi]
PST - epublish
SO  - Radiat Oncol. 2013 May 4;8:113. doi: 10.1186/1748-717X-8-113.